Provider Demographics
NPI:1952469504
Name:OLIVER, EDDIE EUGENE (MD)
Entity Type:Individual
Prefix:DR
First Name:EDDIE
Middle Name:EUGENE
Last Name:OLIVER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2470 WELLINGTON GREEN DR
Mailing Address - Street 2:STE 308
Mailing Address - City:WELLINGTON
Mailing Address - State:FL
Mailing Address - Zip Code:33414-9321
Mailing Address - Country:US
Mailing Address - Phone:813-495-6434
Mailing Address - Fax:
Practice Address - Street 1:1201 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BELLE GLADE
Practice Address - State:FL
Practice Address - Zip Code:33430-4911
Practice Address - Country:US
Practice Address - Phone:561-996-6571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME53972207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine